中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (2): 254-260.doi: 10.3969/j.issn.2095-4344.2016.02.018

• 组织构建综述 tissue construction review • 上一篇    下一篇

椎间盘退化分子机制研究:现状和展望

张 斌,史建刚,史国栋,刘 洋,郑 冰,孔庆捷,王海波,孙璟川,王 元   

  1. 解放军第二军医大学附属长征医院骨科医院脊柱外科,上海市 200003
  • 收稿日期:2015-11-19 出版日期:2016-01-08 发布日期:2016-01-08
  • 通讯作者: 史建刚,博士,教授,解放军第二军医大学附属长征医院骨科医院脊柱外科,上海市 200003
  • 作者简介:张斌,男,1987年生,河北省黄骅市人,汉族,解放军第二军医大学在读硕士。
  • 基金资助:
    国家自然科学基金(81271351)

Molecular mechanisms of intervertebral disc degeneration: present and future

Zhang Bin, Shi Jian-gang, Shi Guo-dong, Liu Yang, Zheng Bing, Kong Qing-jie, Wang Hai-bo, Sun Jing-chuan,
Wang Yuan   

  1. Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Received:2015-11-19 Online:2016-01-08 Published:2016-01-08
  • Contact: Shi Jian-gang, M.D., Professor, Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • About author:Zhang Bin, Studying for master’s degree, Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Supported by:

     the National Natural Science Foundation of China, No. 81271351

摘要:

文章快速阅读:

 

文题释义:
腰椎退行性病变:腰椎退行性病变是指腰椎自然老化、退化的生理病理过程。腰椎是人体躯干活动的枢纽,而所有的身体活动都在增加腰椎的负担,随着年龄的增长,过度的活动和超负荷的承载,使腰椎加快出现老化。严重的腰椎退行性病变可以引起腰腿痛甚至神经损害,影响工作能力和生活质量。
椎间盘退化相关疾病:椎间盘是由位于中心位置的髓核组织、周边的纤维环、软骨终板以及在头尾端供应营养的毛细血管床组成的。由椎间盘退化临床上可引起椎间盘突出症,椎管狭窄症,马尾神经综合征,脊髓栓系综合征,严重者会引起脊髓损伤,出现足下垂,甚至有截瘫的风险。

 

背景:椎间盘退化是古老而常见的临床疾病之一,其发病机制复杂,受到环境和基因等多种因素影响,其发病的机制仍然存在很大的争议。由于技术的局限性,以往研究对于椎间盘退化分子机制的探讨仍然不够深入,而近年来分子机制研究的有了长足的发展。

目的:通过文献检索分析总结并讨论椎间盘退化的分子机制,为其有效治疗提供基础。
方法:由第一作者用计算机检索中国期刊全文数据库和Medline数据库,检索时间:2005年至2015年,检索词分别为“椎间盘、退化、分子机制、环境因素、基因、基质、降解酶、炎症因子、生化环境、治疗”和“intervertebral disc degeneration,molecular mechanism, environmental factors,Genes,matrix,degradation enzyme,inflammatory factor,biological environment,treatment”,语言分别设定为中文和英文。围绕椎间盘退化的机制,从基因、细胞衰老与凋亡、降解酶与基质和炎性细胞因子等方面进行总结,探讨椎间盘退化的发生机制以及可能的有效方式。

结果与结论:共检索到153篇文章,按纳入和排除标准对文献进行筛选,共纳入52篇文章。结果表明独特的结构和生化特性使得椎间盘易于发生退化。传统的观念认为环境因素(如职业、吸烟)是诱发椎间盘退化的主要因素,而目前越来越多的研究证明基因对椎间盘退化的影响才是最重要的。细胞外基质生成减少,降解酶增加,炎症因子的过表达共同造成椎间盘整体结构的破坏,加速椎间盘退化进程。椎间盘退化的有效治疗需要对其分子机制有详细的理解。尽管目前对于椎间盘退化的分子媒介有了进一步认识,椎间盘内复杂的生化环境对治疗仍是巨大的挑战。 

ORCID: 0000-0001-6617-4917(史建刚)

关键词: 组织构建, 组织工程, 椎间盘, 退化, 分子机制, 环境因素, 基因, 基质, 降解酶, 炎症因子, 生化环境, 治疗, 国家自然科学基金

Abstract:

 

BACKGROUND: Intervertebral disc degeneration is one of the ancient and common clinical diseases. Its 
complex pathogenesis affected by various factors, such as environment and genes, is still in debate. Because of the technical limitations, there is still no deep understanding on the molecular mechanism of intervertebral disc degeneration. However, its molecular mechanism in recent years has made considerable development.
OBJECTIVE: To summarize and discuss the molecular mechanism of intervertebral disc degeneration, thereby providing the basis for the effective treatment.
METHODS: CNKI and Medline databases were retrieved by the first author using computer to search relevant articles published from 2005 to 2015. The key words were “intervertebral disc degeneration, molecular mechanism, environmental factors, genes, matrix, degradation enzyme,inflammatory factor, biological environment, treatment” in Chinese and English, respectively. Mechanisms of intervertebral disc degeneration, involving genes, cell senescence and apoptosis, degradation enzyme and substrate, inflammatory cytokines, were summarized to explore the pathogenesis and possible effective treatment of intervertebral disc degeneration.
RESULTS AND CONCLUSION: Totally 153 articles were initially retrieved and finally 52 articles were included in result analysis according to inclusive and exclusive criteria. Unique structure and biochemical properties of the intervertebral disc are easy to cause intervertebral disc degeneration. Traditionally, environmental factors, such as occupation and smoking, are considered as the main factors inducing intervertebral disc degeneration; however, more and more studies have shown that genes have the most important influence on intervertebral disc degeneration. Declined extracellular matrix, increased degradation enzymes, and overexpression of inflammatory factors can all destroy the entire structure of intervertebral disc, and accelerate the process of intervertebral disc degeneration. Effective treatment for intervertebral disc degeneration can be formulated depending on the deep understanding on its molecular mechanisms. Although there is a further understanding on the molecular medium of intervertebral disc degeneration, the complex biochemical environment within the intervertebral disc is still a great challenge to the treatment of intervertebral disc degeneration.
中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程